Doxycyclin

dr.joandr.joan عضو ماسي
تم تعديل 2009/06/26 في أدوية الطوارئ Emergency drugs
Doxycyclin :
Trade names: Doxylin, Doxypal, Doxypharm, Doxacylin. Apo-
Doxy, Doryx, Doxy-Caps, Doxycin
Doxychel Hyclate, Doxytec, Novo-Doxylin , Nu-
Doxycycline ,Vibra-Tabs, Vibramycin
Class: Antibiotic, tetracycline.
Pregnancy: (Category D)
Therapeutic actions
Bacteriostatic: inhibits protein synthesis of susceptible bacteria, causing cell death
Indications
  • Infections caused by rickettsiae; M. pneumoniae; agents of psittacosis, ornithosis, lymphogranuloma venereum and granuloma inguinale; B. recurrentis; H. ducreyi; P. pestis; P. tularensis; B. bacilliformis; Bacteroides; V. comma; V. fetus; Brucella; E. coli; E. aerogenes; Shigella; A. calcoaceticus; H. influenza; Klebsiella; D. pneumoniae; S. aureus
  • When penicillin is contraindicated, infections caused by N. gonorrhoeae, T. pallidum, T. pertenue, L. monocytogenes, Clostridium, B. anthracis; adjunct to amebicides in acute intestinal amebiasis
  • Oral tetracyclines used for acne, uncomplicated adult urethral, endocervical or rectal infections caused by C. trachomatis
  • Unlabeled use: prevention of "traveler's diarrhea" commonly caused by enterotoxigenic E. coli
Contraindications/cautions
v Allergy to tetracyclines,
v renal or hepatic dysfunction,
v pregnancy, and
v Lactation.

Dosage form:
Available Forms: Tablets--100 mg; powder for oral suspension--25 mg; syrup--50 mg; powder for injection--100, 200 mg
Dose:
§ 200 mg on first day, then 100 mg daily; severe infections (including refractory urinary-tract infections), 200 mg daily
§ Early syphilis, 100 mg twice daily for 14 days; late latent syphilis 200 mg twice daily for 28 days
§ Uncomplicated genital Chlamydia, non-gonococcal urethritis, 100 mg twice daily for 7 days (14 days in pelvic inflammatory disease
§ Anthrax (treatment or post-exposure prophylaxis 100 mg twice daily;
§ Child(only if alternative antibacterial cannot be given) [unlicensed dose] 5 mg/kg daily in 2 divided doses (max. 200 mg daily)
§ Geriatric or Renal Failure Patients:
IV doses of doxycycline are not as toxic as other tetracyclines in these patients.
Adverse effects
  • GI: Fatty liver, liver failure, anorexia, nausea, vomiting, diarrhea, glossitis, dysphagia, enterocolitis, esophageal ulcer
  • Hematologic: Hemolytic anemia, thrombocytopenia, neutropenia, eosinophilia, leukocytosis, leukopenia
  • Dermatologic: Phototoxic reactions, rash, exfoliative dermatitis (more frequent and more severe with this tetracycline than with any others)
  • Dental: Discoloring and inadequate calcification of primary teeth of fetus if used by pregnant women, discoloring and inadequate calcification of permanent teeth if used during period of dental development
  • Local: Local irritation at injection site
  • Other: Super infections, nephrogenic diabetes insipidus syndrome
Clinically important interactions
  • Drug-drug
· Decreased absorption with antacids, iron, alkali
· Decreased therapeutic effects with barbiturates, carbamazepine, phenytoins
· Increased digoxin toxicity with doxycycline
· Increased nephrotoxicity with methoxyflurane
· Decreased activity of penicillins
  • Drug-food
· Decreased effectiveness of doxycycline if taken with food, dairy products
  • Drug-lab test
· Interference with culture studies for several days following therapy
Nursing consideration:
· Administer the oral medication without regard to food or meals; if GI upset occurs, give with meals.
· Do not give with antacid, milk, or any product that contains Calcium, Zink, aluminum, magnesium, and ferrous salts, because these products decrease the absorption of the drug.
· Protect patient from light and sun exposure.
· Report rash, itching; difficulty breathing; dark urine or light-colored stools; pain at injection site